I want to concur with Marie Davis. I am usually nomail on lactnet, but a
colleague sent me Marie's posting. I no longer use any of the techniques I
originally learned when I studied to take my IBLCE boards. Leaning from the
babies, and other mammals, and from moms, I always respect mother's
instincts, and infant's natural capabilities, and let the babies learn to
latch themselves, with support and encouragement from moms. AS Dr. Nils
Bergman says, breastfeeding is NOT a behavior of MOTHERS, it is a behavior
of BABIES.
The films from Widstrom and from Righarde and Alade are great as far as they
go, but they have led most to conclude that it is the first hour, or first
24 hrs, that is important, and that we shouldn't interfere with that time,
and then they go ahead and interfere with all the rest of the time. But
baies can latchthis way at any time, I agree with Marie, they keep this
instinct for a long long time, but it can be interfered with by all the
shoving and negative feedback that teaches and aversive response, and tenses
the infan'ts muscles.
The reason it works in those first 24 hrs, is not just that the babies are
primed after birth, but because we leave them alone, skin on skin with mom,
and let them do their own thing. We should continue to let them hang out and
relax with mom. Separation is the problem. Clothes are the problem. Clocks
are the problem. Presuming infant incompetence is the problem.
Kangaroo care 24/7 would be physiological, and great if mom wants, but less
than that if that is culturally unacceptable to her. And we do whatever we
need to do, to help relax mom, so that she can do whatever she needs to do
to relax the baby. Even, heaven forbid, formula, if she can't figure out any
other away to calm her baby down, and to relax her own muscles so that she
can feel comfortable following her infant's lead.
When you let babies do it, the arms don't get in the way, there is no suck
dysfunction, the baby can get a nice assymetric latch without pinching, etc.
So much of the way we teach moms and babies is the cause of all the later
dysfunction LCs are then called in to treat. Since I discovered that babies
can do this, and stopped using my old put the baby in such and such
position, tickle the lips, and RAM, all those issues went away.
The way we teach latch, is as if we taught babies to walk by grabbing their
ankles and putting one foot in front of the other. They'd all end up
refusing to walk!
Below I've pasted my handout that I give to moms, after they've spent an
hour or two with us. It's pretty brief, and summarizes a lot of what we
cover in a few words, but it should give you the idea.
I've seen babies of all ages do this, including a 3 month old fully formula
fed infant who had never ever been put to breast, whose mother was
considering
inducing lactation, who just popped right down and latched in less than a
minute-- because she happened to be in the right frame of mind when we
happened to put her to breast. It does not always happen right away, or in
your office, although pretty much all the babies, if awake will get
themselves down to the nipple, but whether or not they latch on depends on
how hungry sleepy they are, how relaxed mom is, relaxed they are, and mostly
what their most recent experiences at the breast have been.
Luckily, if they've been shoved to the breast, they just need a few days
off, no tries at all, and lots of time, skin on skin, when they are full,
post feeding by
bottle or whatever mom wants, cozy on mom's chest, not hungry enough to
search down to the breast, just melting on moms chest, to remember this is
where baby loves to be, and to reclaim it as a safe place where nobody
shoves.
My handout: The boldface and italics will probably not get to the list, so
I'll substitute CAPs in a few places. There are also bulleted lists, and I
don't know if that will come thru.
Christina M. Smillie, MD, IBCLC 203-375-5812
Breastfeeding Resources, 2505 Main Street, Suite 223, Stratford, CT 06615
Learning to Latch
Newborns and babies of all ages have the ability to find the breast all by
themselves, and to latch on by themselves, just as puppies and kittens do.
We don’t MAKE our babies learn to latch, we ALLOW them to learn.
FIRST step: Start with a calm baby
A mother can help her baby learn by keeping her baby calm and focused.
Babies have more control over their movements when they are calm.
Skin on skin, baby’s chest on your upper chest.
Hold your baby in a vertical position, between your breasts
Start with the baby asleep, or in very mild hunger. Let the baby wake
up on you.
We have to be on baby time. If the baby wants to sleep, fine.
When your baby begins to stir,
Talk to him. Make eye contact if he opens his eyes. Get his
attention.
Stroke him. Keep him calm and relaxed.
NEXT: Follow your baby’s lead.
As he gets hungry, he will start twisting his body toward one breast or the
other, and may begin bobbing his head up and down, looking for the breast.
As he moves his head down toward one breast, you can help by moving his
rear up towards the other.
Support neck and shoulders, while allowing his head freedom to move.
Keep talking to him, help him stay focused.
Help him feel snug and supported (no flailing legs!).
Keep face and cheek touching breast. He knows it by feel, not by sight.
Line up nose to nipple, chin and lower lip touching the breast.
Baby can then reach with his upper lip up and over nipple to an
“off-center” latch.
A comfortable latch allows him to get milk, and swallowing milk is what
teaches him that he is holding his mouth correctly.
Once he’s had a little practice, he’ll “get it” and you won’t have to
do all of this.
IF the baby is too tight or agitated, calm the baby by:
1. Moving him up away from the nipple. (Keep the breast a happy place to
be!) 2. Move him back upright between your breasts. Stroke him.
3. Eye contact, talking to him; “shhhhhhhh”
4. Letting him/her suck on your finger, soft side up at the palate.
5. Handing baby to daddy or grandparent.
(6. Feeding a little breastmilk or formula-- 1/2 to 1 ounce or so.)
As soon as the baby has calmed down, put baby back to your chest, and let
baby look for breast again.
Tina Smillie
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